Prevent attacks – this is the primary focus with these patients.

Preoperative preparation – typically includes potassium depletion with diuretics, maintenance of blood glucose (maintaining normal to high normal levels)

Avoid hypothermia – In all cases. Interventions to maintain normothermia should be considered even in patients undergoing cardiac bypass.

Drugs to avoid – any drug that would increase blood levels of potassium (eg. succinylcholine)

IV calcium – have readily available in the event that signs of hyperkalemia appear.

Neuromuscular blockade – Nondepolarizing muscle relaxants are safe. Succinylcholine is generally avoided as it raises blood potassium levels.

This neuromuscular disorder is caused by a defect in skeletal voltage-gated calcium ion channels. In most cases it is hereditary (autosomal dominant inheritance).

Periodic paralysis, in general, results in skeletal muscle weakness but spares muscles of respiration.

Hyperkalemic periodic paralysis is much rarer than the hypokalemic form. If weakness is provoked by a dose of oral potassium, this would confirm hyperkalemic periodic paralysis.